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ISO, Deadly New Street Drug


Isotonitazene, also known as nitazene or ISO, is a synthetic opioid relatively new to the United States. In 2019, the substance was found in the Midwest and gradually moved into surrounding states. The drug acts as a potent narcotic opioid analgesic and is stronger than heroin and morphine. Like Fentanyl, ISO is typically mixed with other drugs on the black market to make substances stronger and less expensive to create. 

As a result, ISO is prone to causing overdoses, particularly in those unaware that they are ingesting the drug. Provisional CDC data states that, in 2021, 75% of overdose deaths were directly related to a synthetic opioid. As ISO use spreads throughout the country, people must remain vigilant about the signs of ISO abuse, addiction, and overdose.

What Is Isotonitazene?

Isotonitazene, also known as ISO, is a synthetic opioid that has similar effects to the highly publicized drug fentanyl but has a different chemical structure. The chemical composition of ISO resembles that of etonitazene, a controlled substance used as an analgesic. 

Synthetic opioids such as ISO are sold on the black market as a white powder, but they may also be within synthetic cannabinoids. In contrast, a licensed healthcare provider may prescribe medical synthetic opiates like fentanyl as patches, pills, and solutions for injection.

Etonitazene is a drug that was developed in the 1950s that is known to be more potent than morphine. Although ISO is not as strong as etonitazene, its toxicity level is similar to that of fentanyl. Due to this, even minimal doses of ISO can be fatal.

In 2018, ISO appeared in the UK, Sweden, and Germany. Shortly after that, people identified the drug in North America. Since 2020, deaths related to synthetic opioids have increased by 56%, but it is challenging for researchers to gather substantial information about Isotonitazene because it is a relatively new substance. As with most other synthetic opioids, ISO is often within other substances. Due to this, people often ingest ISO unknowingly, thus increasing instances of accidental overdoses.

The Side Effects of Isotonitazene

There is limited research on the side effects and toxicity of isotonitazene. However, the available information suggests that the impact of ISO is similar to that of other synthetic opioids, which include the following:

  • Pain relief
  • Euphoria
  • Relaxation
  • Drowsiness

Synthetic opioids such as ISO pose the same physical health risks as natural opioids. However, since synthetic opioids are more potent than natural opioids, it is easy for users to unknowingly take large doses of ISO. As a result, those who ingest ISO may experience adverse effects, including:

  • Excessive itching
  • Nausea and vomiting
  • Lethargy
  • Loss of consciousness
  • Fainting or dizziness
  • Slowed breathing or respiratory arrest
  • Coma
  • Death

Synthetic opioids, such as ISO, have a higher risk of overdose and death if a person combines them with other substances that compromise breathing, which includes alcohol, benzodiazepines, or other opiates. 

People that inject synthetic opioids are also at a high risk of damaging their veins and arteries, which increases the risk of gangrene, blood clots, thromboses, and infections. Furthermore, injecting substances comes with the risk of spreading viral infections, including hepatitis and HIV.

Signs of Isotonitazene Abuse and Addiction

Although prescription opioids can be beneficial for managing chronic pain, these substances are only to be taken as directed by those with a prescription. Individuals who abuse synthetic opioids are at a high risk of developing an addiction. People who develop an addiction to synthetic opioids such as ISO may experience social harms, including committing crimes to obtain synthetic opioids, declining health, and decreased social functioning.

When a person consumes natural or synthetic opioids, the chemicals bind to the individual’s opioid receptors and increase dopamine in the brain, which increases the feeling of pleasure. The effects of synthetic opioids mimic that of the body’s natural endorphins. Repeated opioid abuse causes the individual to develop a tolerance, meaning they will need to consume more of the substance to experience pleasurable effects.

If you suspect that a loved one may be abusing synthetic opioids such as ISO, consider performing a drug trust to confirm whether or not they are using. With early identification and intervention, people can safely undergo treatment for synthetic opioid abuse.

The signs of isotonitazene abuse and addiction include the following:

  • Isolating oneself from loved ones
  • Declining work or school performance
  • Angry emotional outbursts
  • Changes in appearance such as drastic weight loss or poor hygiene
  • Drastic mood swings
  • Poor decision making

Signs of Isotonitazene Withdrawal

If a person abuses ISO or develops an addiction to ISO, they may experience withdrawal if they stop using the substance. Withdrawal is a painful, high-risk experience during which the body attempts to function without opioids. 

Symptoms of ISO withdrawal include the following:

  • Muscle spasms
  • Abdominal cramping
  • Extreme cravings for synthetic opioids
  • Insomnia
  • Digestive issues, including diarrhea and vomiting

Signs of Isotonitazene Overdose

When an individual consumes a higher dose of a substance than their body can metabolize, it is called an overdose. An overdose is extremely dangerous and could be fatal. If you or someone you know has taken ISO and exhibits the following symptoms, seek medical attention immediately:

  • Small pupils
  • Slowed heart rate
  • Shallow breathing
  • Seizure
  • Bluish color on lips and fingertips
  • Decreased alertness

Identify Isotonitazene Abuse with Countrywide Testing

If you suspect that a loved one may be using isotonitazene, there are resources available that will assist you in detecting illegal drug or dietary supplement use. 

Countrywide Testing is an online retailer of many health-related diagnostic test devices, including drug tests. If you’re concerned that a loved one may abuse an illegal drug, let Countrywide Testing offer you peace of mind with our FDA-approved at-home drug testing kits.

Our drug kits are all analyzed with laboratory services from Phamatech, Inc, a SAMHSA, ISO, CLIA, and CAP licensed laboratory, to provide you with fast and reliable results that you can trust.

When you need answers, Countrywide is there. Contact us today to learn more about how we can help!